In previous gastrostomy, two puncture needles were punctured from the body surface to the stomach wall, a suture was inserted from one of the puncture needles, and the suture was hooked by the loop body which was inserted from the other needle and captured, thereby forming the loop. Stomach is lifted by pulling the looped suture, and the body wall and the stomach wall are fixed by further tying the sutures together with each other. Thereafter, the large through hole is formed in the body wall and the stomach wall by deeply puncturing the guidewire and dilator from the body surface, and the stomach fistula is established by indwelling the indwelling catheter there.
In a general gastrostomy, it is necessary to fix the body wall and the stomach wall is in at least three positions (possibly four positions) so as to surround the gastrostomy scheduled portion. After the stomach fistula is established, the sutures are cut and removed.
This method is a highly invasive because it is necessary to puncture the two puncture needles in respective fixing positions, and in some cases it is difficult to capture the suture by the loop body in the stomach due to the skill of the doctor.
On the other hand, it became possible to be low invasive and easy procedure according to the instrument of Patent Document 1 (prior art), since the stomach wall can be fixed to the body wall by only one puncture needle, as shown in FIG. 11, and the like. According to this procedure, it became unnecessary to loop the suture since the procedure can be performed with a single puncture needle by inserting T-shaped suture instrument in which the suture is engaged with the center of the rod-shaped engaging portion rod and lifting the stomach wall, instead of tying the two sutures.
The instrument of Patent Document 1 takes a form in which it is possible to individually push out a plurality of suture instruments housed in the internal portion of the puncture needle (hereinafter referred to as repeating type). Specifically, four suture instruments are housed in the puncture needle. Thus, upon fixing the gastric wall to the body wall at three to four positions in one procedure, it is possible to achieve this with one instrument. Therefore, it is easy because the replacement operation such as discarding, opening or switching of the instrument becomes unnecessary.
In the suturing tool of Patent Document 1, one suture is engaged with the engaging portion. When fixing the suturing tool to the body surface, the suture is tied together with the suture of the other suture instrument on the body surface.
Similarly, in Patent Document 2, an organ fixing instrument using a T-shaped suture instrument is described. This instrument uses a suture instrument in which one looped suture is engaged with the rod-shaped engaging portion (rod). This organ fixing instrument takes a form in which only one suturing tool is equipped with in the internal site of the puncture needle (hereinafter referred to as single-type). The pad-like cushioning material is attached to the suture. The cushioning material is pressed against to the body surface, and the sutures entangled with each other are tied to the cushion material in a state of the two strings by cutting the suture loop. Thus, it is possible to fix each individual suture instrument to the body surface at 3 to 4 points of the fixed locations.